Information Collection

Electronic Records Express Third-Party Registration and Request Screens

IC 181427 under ICR 202310-0960-005 · OMB 0960-0767.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
ERE Screen Shots (revised).pdf www.ssa.gov/representation/	Other-Screen Shots
ERE Screen Shots (revised).pdf www.ssa.gov/representation/	Other-Screen Shots
ERE Screen Shots (current).pdf ERE Screenshots (current)	IC Document
ERE Screen Shots (current).pdf ERE Screenshots (current)	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screen Shots			ERE Screen Shots (revised).pdf	http://www.ssa.gov/representation/	Yes	Yes	Fillable Fileable Signable

Line of Business: Income Security

Subfunction: General Retirement and Disability

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 37,314

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	3,022,434	3,022,434
Annual IC Time Burden (Hours)	50,374	50,374
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
ERE Screenshots (current)	ERE Screen Shots (current).pdf	10/26/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.